Caregiving Questions About Insurance and Paying for Care

Expert Elinor Ginzler answers reader questions

En español | The AARP Caregiving Advisory Panel answers your questions about caregiving and health insurance, Medicare, Medicaid and paying for care. This page will continue to be updated with answers as we receive your comments and questions. Can't find an answer to your question below? Send us your query.

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Q. Can I get paid for taking care of my parents?

Elinor Ginzler: There is no question that caring for an older parent is work. Mostly, it is what we would call a labor of love, because it is usually unpaid work. However, many people wonder if there is a way for family members to be paid for the care they provide their older loved one. The answer is: It depends. Some long-term care insurance policies include as a benefit the option of paying friends or family. A few states are trying out programs in which family members can be paid. For more information, check the AARP article "Can I Get Paid as a Caregiver?".

Q. Do most assisted living homes accept Medicare/Medicaid?

Elinor Ginzler: Medicare does not cover the cost of assisted living. It's a common misperception. In some states, there is some funding for those who are eligible for Medicaid (both financially and medically) to cover part of the cost of assisted living. Each state decides if it is interested in using some of its Medicaid funding from the federal government for assisted living and can apply for a waiver to get permission. If that does occur, it covers only a certain limited number of slots, so there are always long waiting lists. More than 80 percent of assisted living is paid for privately.

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Q. My mother has limited mobility and needs help bathing, using the toilet and taking medications. Where can we find agencies that will provide these services? Will insurance cover it?

Elinor Ginzler: Unfortunately, neither Medicare nor a Medicare Supplemental Insurance plan will pay for ongoing personal care and housekeeping. Check with your Area Agency on Aging and find out what services are available in your community, including home care agencies that use sliding scales to help with affordability. It might be time to consider moving her to a care facility. She needs round-the-clock care and that can be too much for one, or even two, people. If home care can't be arranged, an assisted living or nursing home, depending on her level of functioning, may be the real solution.

Q. I am 62 years and I take care of my mother, who is 94. I plan to take the time off through the Family Medical Leave Act, after I use all my vacation. Does the FMLA let me keep my insurance at the price that I pay on the job?

Elinor Ginzler: The FMLA gives employees the opportunity to take leave to care for family without the fear of losing one's job. Your question is a good one. Your employer is required to maintain group health insurance for an employee on FMLA leave, if the insurance was provided before the leave was taken, according to the federal Department of Labor. Arrangements would need to be made for you to pay your share of the premiums while you are on leave. For more information, check the Department of Labor website.

Q. Medicaid is paying for my mother's nursing home stay after she fell, but there are staff shortages and her care is lacking. Will Medicaid help pay for an additional aide in the nursing home?

Elinor Ginzler: Sorry, there are no public funds available to offer additional private aide services in a nursing home. The nursing home should provide adequate care. If you think your mother's care is substandard, contact your local long-term care ombudsman office and ask it to investigate your complaint. Be as specific as possible about your care concerns. To find your local ombudsman, go to the National Long-Term Care Ombudsman Resource Center.